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Individual
SAMANTHA J KIRK
Active
Individual
SAMANTHA J KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71013673A
IN
363LF0000X
Family Nurse Practitioner
Primary
71013673A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090540879
MEDICARE PTAN
IN
Enumeration date
03/09/2023
Last updated
10/13/2023
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